1971, 03-26 Permit App: I3820 ResidenceCounty of Spokane, Washington
BUILDING CODES DEPARTMENT, COURTHOUSE, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT 61L"
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any
kind or alter any building or structure already erected, or to change a land use. Construction most conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Water supply must be approved by the County and State Health Departments. Where work on water connections disturbs
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos. 45-133 and 47.235.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, of at
least 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard are required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
and egress.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
performed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer.
MOVING OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a County or State
Highway, clearance must be obtained from the County Engineer and/or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running with the land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE
Name of Owner
�v Address
Architect Pone Engineer
�'� Address
Contractor 5s' 1 Sire �'
Leg l Driptio, ofi•roperty (Give com
Phone hint-c's“
Phone U/ f}6-337*1
/�'�� Ph one iU t— 7
ete description from deed, tax receipt, etc.) tic, C- Z 9
DESCRIPTION OF WORK: New t ------Addition
Size of Lot D a 2-(r
Const.' 17L0..12- Dimensions
(Frame, concrete, brick, etc.) . sa/ /s
Rooms � Baths � Basement Founda ion Co st�
Remodel
Moving Bid!, Zon- Fire Zone
Sewage System
tal Sq Ft //Jf
-e••-•('-=-4•16 Chimney84-Z4 Fire. lace
(Kind) / (Numb
Int. Wall Finish - -
Stories / t—�_
Valuation o7 4j 660
Heat. System ! (Full, part, one)
/ T pe of - oofing Ext Finish
Use of Bldg.
i
en
or Carport Attached
PLOT PLAN
w sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
sed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
and water supply lines.
No. of Units Bedrooms
Private Detatched
NORTH
I hereby cer
as shown.
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.3`-7 6
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State License No.
22-3 01 /06/2--
Ind.
06/Z
Ind. Ins. Acct. No.
.2-77) a -to
RE
Plumbing Permit
Heating Permit
Sewage Permit
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
is correct and there are no other strut ures 1. ated on this property except
Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS IS NOT A PERMIT.
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Your street address will be The zone is
Sewage Permit Number Isaued Building Permit Receipt 5'3 � Issued
Remarks
DO NO WRITE BELOW THIS LINE
Form 523 Bldg. Code
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SPOKANE COUNTY HEALTH DISTRICT
North 819 refiurson Street
Spokane, Washington 99401
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